This 2012 meta-analysis of 20 studies and over 15,000 patients asks whether obesity (BMI ≥30 kg/m²) worsens infection, revision, and functional outcomes after primary total knee arthroplasty compared to nonobese patients. Data were pooled using Cochrane methodology, with weighted odds ratios calculated for dichotomous outcomes and weighted mean differences for continuous outcomes.
Consenting an obese patient for TKA used to rely on limited, conflicting single-center data — several large studies showed no difference, making it hard to counsel patients with confidence.
This meta-analysis resolves that ambiguity with specific, pooled numbers: roughly double the infection risk and a revision rate that starts 30% higher and climbs to nearly twice the nonobese rate beyond five years.
When you see an obese patient in clinic requesting TKA, use these figures directly in the consent conversation. Not as a reason to deny surgery, but to set accurate expectations and trigger perioperative optimization.
The authors' framework is practical: refer to a multidisciplinary obesity clinic, optimize medical comorbidities, and proceed with TKA if weight loss fails. Because withholding surgery is not supported by this evidence.
This 2012 meta-analysis of 20 studies and over 15,000 patients asks whether obesity (BMI ≥30 kg/m²) worsens infection, revision, and functional outcomes after primary total knee arthroplasty compared to nonobese patients. Data were pooled using Cochrane methodology, with weighted odds ratios calculated for dichotomous outcomes and weighted mean differences for continuous outcomes.
Consenting an obese patient for TKA used to rely on limited, conflicting single-center data — several large studies showed no difference, making it hard to counsel patients with confidence.
This meta-analysis resolves that ambiguity with specific, pooled numbers: roughly double the infection risk and a revision rate that starts 30% higher and climbs to nearly twice the nonobese rate beyond five years.
When you see an obese patient in clinic requesting TKA, use these figures directly in the consent conversation. Not as a reason to deny surgery, but to set accurate expectations and trigger perioperative optimization.
The authors' framework is practical: refer to a multidisciplinary obesity clinic, optimize medical comorbidities, and proceed with TKA if weight loss fails. Because withholding surgery is not supported by this evidence.